Only half the pregnant women booking into one of Dublin's main maternity hospitals are of normal weight, a report has revealed.
The annual report of the Coombe Women's and Infants University Hospital said nearly one in five of the women was obese and 1.8pc were morbidly obese; one-third were overweight and 1.6pc were underweight.
Being obese during pregnancy increases the risk of various complications, including risk of miscarriage, stillbirth and having to deliver the baby by caesarean section.
If a woman is overweight, the best way to protect her health and her baby's well- being is to lose weight before the pregnancy.
By reaching a healthy weight, a woman increases the chances of conceiving naturally and reduces the problems associated with being overweight in pregnancy. The report revealed that in 8,941 mothers were cared for at the hospital in 2016 and 8,421 babies were born.
A lifestyle questionnaire found that half were not taking folic acid before conception, even though it can reduce the risk of a neural tube defect such as spina bifida.
One in five never had a cervical smear performed, and 1pc were drinking alcohol although pregnant and one in 10 was a current smoker.
The report said exclusive breastfeeding rates remain low by international standards, at 38.2pc.
There were no maternal deaths at the hospital, and adjusted perinatal mortality rate for babies at or around the time of birth was 2.6 per 1,000 births.
Birth defects and prematurity with respiratory problems were the main causes of early neonatal death.
Coombe master Dr Sharon Sheehan said there has been a significant increase in the number of women attending the diabetic clinic.
Attendances went up by 30pc after the introduction of the latest international guidance on the disease.
Difficulties getting staff remained across various areas including medical, midwifery and nursing.
Recruitment and retention remains a major concern during the year.
The report showed that more than one in 10 women had a previous caesarean section.
The hospital's overall caes- arean section delivery rate is 31.3pc.